Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams

1 Community-Based Health Care Research Unit, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia

2 National Centre for Clinical Outcomes Research (NaCCOR), Nursing and Midwifery, The Australian Catholic University, Australia

3 Nursing Research Institute, St Vincent's and Mater Health Sydney and the Australian Catholic University, New South Wales, Australia

BMC Health Services Research 2010, 10:18
doi:10.1186/1472-6963-10-18

Published: 19 January 2010

Abstract

Background

Transferring knowledge from research into practice can be challenging, partly because
the process involves a change in attitudes, roles and behaviour by individuals and
teams. Helping teams to identify then target potential barriers may aid the knowledge
transfer process. The aim of this study was to identify barriers and enablers, as
perceived by allied health professionals, to delivering an evidence-based (Level 1)
outdoor journey intervention for people with stroke.

Methods

A qualitative design and semi-structured interviews were used. Allied health professionals
(n = 13) from two community rehabilitation teams were interviewed, before and after
receiving feedback from a medical record audit and attending a training workshop.
Interviews allowed participants to identify potential and actual barriers, as well
as enablers to delivering the intervention. Qualitative data were analysed using theoretical
domains described by Michie and colleagues.

Results

Two barriers to delivery of the intervention were the social influence of people with
stroke and their family, and professionals' beliefs about their capabilities. Other
barriers included professionals' knowledge and skills, their role identity, availability
of resources, whether professionals remembered to provide the intervention, and how
they felt about delivering the intervention. Enablers to delivering the intervention
included a belief that they could deliver the intervention, a willingness to expand
and share professional roles, procedures that reminded them what to do, and feeling
good about helping people with stroke to participate.

Conclusions

This study represents one step in the quality improvement process. The interviews
encouraged reflection by staff. We obtained valuable data which have been used to
plan behaviour change interventions addressing identified barriers. Our methods may
assist other researchers who need to design similar behaviour change interventions.